Medical Health Encyclopedia

Certified Nurse Midwife profession (CNM)

Numerous studies over the past 20-30 years have documented the ability of nurse-midwives to independently manage about 80% of all perinatal (including prenatal, delivery, and postpartum) care and up to 85% of the family planning and gynecological needs of women of all ages.

Nurse-midwives work in a collaborative role with OB/GYN physicians and either consult with or refer to other health care providers on cases outside their scope of practice (for example, high-risk pregnancies and pregnant women who also have a chronic disease). See types of health care providers.

SCOPE OF PRACTICE

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The nurse-midwife is prepared both academically and clinically to provide a broad range of health care services for women and newborns. CNM functions include diagnostic services (history taking, physical assessment, ordering appropriate laboratory tests and procedures), therapeutic management (outlining care, providing prescriptions, coordinating consultations and referrals), and health promotion and risk-reduction activities.

Although the majority of CNM practice may focus on childbearing, family planning, and gynecological care for well women, CNMs may also assess and manage common illnesses in adults. All services are performed in collaboration with the client.

As with the nurse practitioner profession (NP), CNMs are legally allowed to write prescriptions in some states but not others. Health care management by CNMs includes independent management, consultation or co-management, and referral services.

PRACTICE SETTINGS

Certified nurse-midwives may be found in a variety of settings including private outpatient practices (either by themselves or in collaboration with a physician), health maintenance organizations, hospitals, health departments, and freestanding birthing centers. Traditionally, CNMs have provided care to underserved populations in rural areas or inner-city settings.